Medical instruments that are utilized for conducting routine patient examinations are well known. For example, ophthalmoscopes are diagnostic instruments that are specifically configured for examining various aspects of the eye. A typical direct ophthalmoscope 10, depicted in FIG. 1(a), is defined by an instrument head 12 that is supported by a handle portion 13, the latter having an interior that is configured to retain a set of batteries (not shown) as well as a light source (not shown). A flexible and compressible eyecup 14 is releasably attached to a distal end 16 of the instrument head 12 that directly engages the patient (not shown), with an eyepiece 17 being provided at an opposite proximal end 19 of the instrument head 12. In use, the contained light source (not shown in this view) creates a beam that is directed using contained optics to the distal end 16 of the device 10 and onto the eye of a patient (not shown). Reflected light, in the form of an image of the back of the eye, is then transmitted along a contained imaging assembly of the instrument 10 to the eyepiece 17 for viewing by a caregiver (not shown).
Alternatively, a similarly configured ophthalmoscope 20 having an instrument head 22 and a handle portion 23 can utilize an electronic imaging device 27, such as a smartphone, as shown in FIG. 1(b), which can be attached to a holding or support fixture 28 that engages the proximal end 29 of the instrument head 22 in lieu of an eyepiece, the instrument head 22 further supporting an eyecup 24 to interface with the patient. Accordingly and in operation, an image of the eye can be captured and transmitted via a contained imaging system to the contained imager of the attached device 27. Specific details relating to the foregoing eye viewing instruments are described in U.S. Pat. No. 7,784,940 B2, incorporated by reference herein in its entirety.
Examinations of the ear are also a common procedure that is conducted during routine patient visits by a caregiver using an otoscope. A typical otoscope 30, illustrated in FIG. 2(a), includes an instrument head 32 that is attached to a handle portion 34 having an interior sized to accommodate a set of batteries 35, as well as a light source, such as an incandescent lamp 36. An axisymmetric insertion portion 38 extending from the distal end 39 of the instrument head 32 is configured to receive a disposable speculum tip or tip member 40 (shown in phantom), the latter being a hollow disposable component defined by an axisymmetric configuration having a distal tip opening 42 and an opposing proximal tip opening 43. The speculum tip 40 includes an internal feature (not shown) that is sized to engage a circumferential bayonet slot 41 formed on the exterior of the axisymmetric insertion portion 38. The speculum tip 40 is further defined by a conical tapering configuration that prevents the speculum tip 40 from being inserted beyond a predetermined distance into the ear canal (not shown) of a patient. The proximal end 37 of the instrument head 32 is provided with a viewing window 45 that can include a magnifying optic 46. In use, the contained incandescent lamp 36 is illuminated using a switch 48 located on the handle portion 34 and emitted light is directed to the speculum tip 40 using a set of optical fibers 44 having a polished proximal end that is coupled in relation to the incandescent lamp 36. The distal end (not shown) of the optical fibers 44 are disposed to encircle the distal opening 39 of the axisymmetric insertion portion 38. This transmitted light is then circumferentially directed through the distal tip opening 42 of the attached speculum tip 40, the latter having a polished interior surface to promote transmission, to enable viewing of the patient's ear canal and the tympanic membrane (not shown). This light is reflected for viewing by a caregiver at the viewing window 45 to determine the presence of infections, including otitis media.
More recently, otoscopes 60 have been developed including optical assemblies disposed within the instrument head that enable enhanced viewing by a caregiver or through an attached electronic imaging device. One example, depicted in FIG. 2(b), is manufactured and sold under the tradename of Macroview by Welch Allyn, Inc. and further described in U.S. Pat. No. 7,399,275, incorporated herein in its entirety by reference. This instrument 60 includes an instrument head 62 that is attached to the upper end of a handle portion 63, the latter retaining a set of rechargeable batteries (not shown), as well as a light source (not shown), such as an LED or lamp. As in the preceding, a speculum tip or tip member 66 is releasably attached to a distal end 73 of the instrument head 62, the speculum tip 66 being defined by a tapering axisymmetric configuration that is hollow and further defined by opposing distal and proximal tip openings. In this instrument version, the proximal end of the speculum tip 66 includes a set of exterior circumferential mounting features 69 that are configured to releasably engage a corresponding set of arcuate slots (not shown) provided in an attachment member 71, the latter being integral to the distal end 73 of the instrument head 62 and disposed in lieu of an axisymmetric insertion portion. The speculum tip 66 is attached by aligning the slots in the attachment member 71 with the proximal mounting features 69, the attachment member 71 being rotatable to effect release of the speculum tip 66.
According to this example, an optical assembly disposed within the interior of the instrument head 62 is configured to create a larger field of view that permits the entire tympanic membrane to be viewed at once, either directly by a caregiver at an eyepiece 67 or alternatively to an electronic imaging device (not shown) attached to the proximal end 75 of the instrument head 62 and aligned with the contained optical assembly. Details regarding the tip attachment mechanism and the operational features of this instrument 60 are provided in the above noted and incorporated '275 patent.
There has been a general pervasive need in the medical field to provide versatility and functionality in diagnostic instruments. For example, both eye viewing and ear viewing devices are commonly used in a single patient examination. Various attempts at instrument consolidation have previously been attempted. For example, Applicants previously invented a single diagnostic instrument as described in U.S. Pat. No. 6,106,457, the entire contents of which are herein incorporated by reference. According to the teachings of this latter '457 patent, a digital camera can be configured with multiple instrument heads that are separately and interchangeably attachable for permitting otological, ophthalmic, skin microscopy and other examinations to be conducted. Each of the separate instrument heads, as described by the '457 patent, however, require a unique optical system and in certain instances may further require a unique illumination system for conducting various examinations of a patient.
As noted, there is a general and continuing need in the field to provide additional versatility and functionality within a single medical diagnostic instrument.